Abstract
Purpose
The goal of this study was to quantified the results of microsurgery, in all the patients with acromegaly treated by the same endocrinologist and the same surgeon between 1975 and 2015.
Methods
A series of 548 patients with acromegaly were operated and followed-up from 6 months to 40 years. Patients were selected according to five criteria: (1) Operated by the same surgeon. (2) No previous treatment. (3) Complete endocrinological preoperative studies including GH, OGTT, IGF-I, PRL test and TC/MRI. (4) Complete postoperative endocrinological evaluation for at least one determination of GH, OGTT, PRL test and IGF-I six months after surgery. (5) All the patients were supervised by the same endocrinologist.
Results
Microadenomas were present in 119 patients and 109 (91,5%) achieved remission. Non invasive macroadenomas were present in 200 patients and 164 achieved remission (82%). Results were worse for invasive macroadenomas but even with great invasions some patients achieved clinical remission. Follow-up range from 6 months to 40 years (mean 3.3 ± 2.3) A long term follow-up of 15 years was achieved in 61 patients. Four of them had a recurrence 4, 7, 8, 12 years after surgery (6.5%). There was not mortality and the rate of complications was low.
Conclusions
Surgery remains the first line of therapy for a majority of acromegalic patients. This series proves to be very valuable in circumscribed adenomas but also in invasive tumours. Levels of GH and IGF-I were decreased in almost all the patients without remission.
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Change history
05 July 2017
An erratum to this article has been published.
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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers´bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.
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For this retrospective study, formal consent is not required.
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All of our patients have signed an informed consent before surgery that included scientific purpose.
Additional information
The original version of this article was revised: The value of PRL in Preoperative hormonal values section is corrected and column headers in Table 3 are corrected.
An erratum to this article is available at https://doi.org/10.1007/s11102-017-0816-8.
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Fernández Mateos, C., García-Uria, M., Morante, T.L. et al. Acromegaly: surgical results in 548 patients. Pituitary 20, 522–528 (2017). https://doi.org/10.1007/s11102-017-0813-y
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DOI: https://doi.org/10.1007/s11102-017-0813-y